Association between class of foundational medication for heart failure and prognosis in heart failure with reduced/mildly reduced ejection fraction

Ito, Miyuki; Maeda, Daichi; Matsue, Yuya; Dotare, Taishi; Sunayama, Tsutomu; Nogi, Kazutaka; Takei, Makoto; Ueda, Tomoya; Nogi, Maki; Ishihara, Shoichiro; Nakada, Yasuki; Kawakami, Rika; Kagiyama, Nobuyuki; Kitai, Takeshi; Oishi, Shogo; Akiyama, Eiichi; Suzuki, Satoshi; Yamamoto, Masayoshi; Kida, Kenji; Okumura, Takahiro; Nagatomo, Yuji; Kohno, Takashi; Nakano, Shintaro; Kohsaka, Shun; Yoshikawa, Tsutomu; Saito, Yoshihiko; Minamino, Tohru

doi:10.1038/s41598-022-20892-3

Cited by 1 publication

(2 citation statements)

References 45 publications

(45 reference statements)

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“…Patients were frequently comorbid with hypertension, CKD, ischemic heart disease, and atrial fibrillation. These findings were in line with the recent reports from large-scale registries in Japan 9 , 20 . We found that one-third of patients initiated new HF medications, of which roughly three in four patients started these medications during hospitalization for HF.…”

Section: Discussionsupporting

confidence: 92%

“…Despite its importance due to the high risk of HF readmission, comorbid burden, and the risk of HF decompensation events, there is currently limited information on changes in HF medications and the persistence of the treatment initiated after worsening HF events in Japan. Retrospective analyses of large-scale registries of patients hospitalized for HF reported the changes in HF medication patterns from admission to discharge; however, the longitudinal data on treatment continuations were lacking 9 , 20 . In a multinational study, patterns of titration and discontinuation of newly initiated GDMT after worsening HF events were reported; however, the study lacked data on other HF medications, such as diuretics and digoxin 21 .…”

Section: Introductionmentioning

confidence: 99%

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Initiation and continuation of pharmacological therapies in patients hospitalized for heart failure in Japan

Okami,

Lecomte,

Raad

et al. 2024

Sci Rep

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Currently, the utilization patterns of medications for heart failure (HF) after worsening HF events remain unelucidated in Japan. Here, we conducted a retrospective cohort study evaluating the changes in HF drug utilization patterns in 6 months before and after hospitalizations for HF. The adherence to newly initiated HF medications was evaluated based on the proportion of days covered (PDC) and persistence as continuous treatment episodes among new users. The study included 9091 patients hospitalized for HF between January 2016 and September 2019, including 2735 (30.1%) patients who were newly prescribed at least one HF medication after hospitalization. Despite increases in the use of foundational HF therapy (beta-blockers, angiotensin-converting-enzyme inhibitors/angiotensin receptor blockers, or mineralocorticoid receptor antagonists), 35.6% and 7.6% of patients were treated with the HF foundational monotherapy or diuretics alone after hospitalization, respectively. The mean PDC of newly initiated HF medications ranged from 0.57 for thiazide diuretics to 0.77 for sodium-glucose cotransporter-2 inhibitors. Continuous use of HF medications during the first year after initiation was observed in 30–60% of patients. The mean PDC and one-year continuous HF medication use were consistently lower in patients aged ≥ 75 years and in patients with a history of HF hospitalization for all HF medication classes except for tolvaptan and digoxin. Despite the guideline recommendations of HF pharmacotherapy, both treatment and adherence were suboptimal after HF hospitalization, especially in vulnerable populations such as older patients and those with prior HF hospitalizations.

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Section: Discussionsupporting

confidence: 92%